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Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC)

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Abstract

Improvements in software and hardware have enabled the integration of dual imaging modalities into hybrid systems, which allow combined acquisition of the different data sets. Integration of positron emission tomography (PET) and computed tomography (CT) scanners into PET/CT systems has shown improvement in the management of patients with cancer over stand-alone acquired CT and PET images. Hybrid cardiac imaging either with single photon emission computed tomography (SPECT) or PET combined with CT depicts cardiac and vascular anatomical abnormalities and their physiologic consequences in a single setting and appears to offer superior information compared with either stand-alone or side-by-side interpretation of the data sets in patients with known or suspected coronary artery disease (CAD). Hybrid systems are also advantageous for the patient because of the single short dual data acquisition. However, hybrid cardiac imaging has also generated controversy with regard to which patients should undergo such integrated examination for clinical effectiveness and minimization of costs and radiation dose, and if software-based fusion of images obtained separately would be a useful alternative. The European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) in this paper want to present a position statement of the institutions on the current roles of SPECT/CT and PET/CT hybrid cardiac imaging in patients with known or suspected CAD.

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Abbreviations

AC:

Attenuation correction

CAC:

Coronary artery calcium

CAD:

Coronary artery disease

CCTA:

Cardiac computed tomographic angiography

FFR:

Fractional flow reserve

HR:

Heart rate

ICA:

Invasive coronary angiography

MACE:

Major adverse cardiac event

MDCT:

Multidetector computed tomography

MPI:

Myocardial perfusion imaging

NPV:

Negative predictive value

PET:

Positron emission tomography

PPV:

Positive predictive value

RCA:

Right coronary artery

SPECT:

Single photon emission computed tomography

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This position statement summarizes the views of the Cardiovascular Committee of the EANM, the ESCR and the ECNC, for which the EANM, European Society of Radiology (ESR) and the European Society of Cardiology (ESC) cannot be held responsible.

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Authors and Affiliations

  1. Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni M. Claret, 167, 08025, Barcelona, Spain

    Albert Flotats

  2. Turku PET Center, Turku University Hospital, Turku, Finland

    Juhani Knuuti

  3. Radiology Department, Herzzentrum Leipzig GmbH, Leipzig, Germany

    Matthias Gutberlet

  4. Cardiology Department, S. Maugeri Foundation, IRCCS, Scientific Institute of Veruno, Veruno, NO, Italy

    Claudio Marcassa

  5. Division of Nuclear Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Frank M. Bengel

  6. Cardiology Department, University of Zurich, Zurich, Switzerland

    Philippe A. Kaufmann

  7. Radiology Department, Bangor, Gwynedd, UK

    Michael R. Rees

  8. Department of Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Birger Hesse

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  1. Albert Flotats
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  2. Juhani Knuuti
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  3. Matthias Gutberlet
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  4. Claudio Marcassa
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  5. Frank M. Bengel
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  6. Philippe A. Kaufmann
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  7. Michael R. Rees
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  8. Birger Hesse
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On behalf of the Cardiovascular Committee of the EANM, the ESCR and the ECNC

Corresponding author

Correspondence to Albert Flotats.

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Flotats, A., Knuuti, J., Gutberlet, M. et al. Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC). Eur J Nucl Med Mol Imaging 38, 201–212 (2011). https://doi.org/10.1007/s00259-010-1586-y

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